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JACOB OMAR KHOUSSINE MD, PHD
NPI 1063354280
Ophthalmology in Portland, ME

Active since April 07, 2026PECOS Enrolled
22 BRAMHALL ST, PORTLAND, ME 04102(207) 662-7068 Get Directions Write a Review

NPPES record last updated: April 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacob Omar Khoussine Md, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB OMAR KHOUSSINE MD, PHD (NPI 1063354280) is an individual ophthalmology provider in Portland, Maine, licensed in Maine (EC261086) and active in the NPI registry since April 2026. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063354280
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameJACOB OMAR KHOUSSINECredential: MD, PHD
Location Address22 BRAMHALL STPortland, ME 04102-3175
Mailing Address4620 Frey St Apt 115Madison, WI 53705-2903 · (405) 808-6005
Phone(207) 662-7068
Sole ProprietorNo
Enumeration DateApril 7, 2026
NPPES CertifiedApril 7, 2026
✔ NPI 1063354280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in ME · EC261086
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
22 BRAMHALL ST, Portland, ME 04102
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Omar Khoussine Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$128.83 typical visit price
range $56.28 – $169.96
Typical copayment $32.20 (range $14.07 – $42.49)
Most-billed visit code 99204
Established Patient
$70.13 typical visit price
range $18.22 – $138.92
Typical copayment $17.53 (range $4.55 – $34.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABBY LYNN LABRECQUE PA-C
Physician Assistant (Medical)
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-8111
TEGAN SWIFT RD
Dietitian, Registered
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-4238
DEREK POULIN DO
Anesthesiology
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-2526
MATTHEW SCOTT AUSTIN CRNA
Nurse Anesthetist, Certified Registered
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-2526
MADELINE YOUNGBERG MD
Internal Medicine
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-0111
ERICA BRASLEY MD
Student in an Organized Health Care Education/Training Program
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-0111
REBECCA ROSE LIGHTMAN
Internal Medicine
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-7060
DR. LUKE PATRICK KEFFER MD, MBA
Student in an Organized Health Care Education/Training Program
22 BRAMHALL ST
PORTLAND, ME 04102
Cumberland County (207) 662-0111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Khoussine's NPI number?

The NPI number for Jacob Khoussine is 1063354280. It was assigned to this individual provider in the NPPES registry on April 7, 2026.

Where is Jacob Khoussine located?

Jacob Khoussine practices at 22 Bramhall St, Portland, ME 04102. The listed phone number is (207) 662-7068.

What is Jacob Khoussine's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Jacob Khoussine enrolled in Medicare?

Yes. Jacob Khoussine is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Khoussine was last updated on April 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.